The NC Certified Community Behavioral Health Clinic Planning Grant DIVISION OF MH/DD/SAS

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES Overview

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES Legislative Mandate Section 223 “Demonstration Programs to Improve Community Mental Health Services” of the PAMA Act Protecting Access to Medicare Act of 2014 (H.R. 4302) Enacted on April 1, 2014

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES Populations Served Adults with serious mental illness Children with serious emotional disturbance Those with long term and serious substance use disorders Others with mental illness and substance use disorders

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES Section 223 Requirements Establish and publish criteria for certification for clinics to enable them to participate in a demonstration program Issue guidance on the development of a Prospective Payment System to be tested during the demonstration program Award planning grants to develop proposals for participation in the two-year demonstration program

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES Certification Criteria Developed by SAMHSA Focuses on the following areas: Staffing Availability of Services Care Coordination Scope of Services Quality/Other reporting Organizational Authority, Governance, and Accreditation

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES Prospective Payment System (PPS) Guidance prepared by CMS States select one of two PPS rate methodologies. –CC PPS-1 FQHC-like PPS that provides reimbursement of cost on a daily basis; optional bonus payments for meeting defined quality metrics –CC PPS Alternative (CC PPS-2) monthly unit of payment; quality bonus payments required

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES The Demonstration Program All states awarded the CCBHC Planning Grants are expected to apply for the demonstration program Eight states will be selected for the demonstration program Selected states will bill Medicaid under a CMS- approved PPS for behavioral health services provided to Medicaid-eligible individuals

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES The NC CCBHC Planning Project A collaboration between DMHDDSAS and DMA Awarded to DMHDDSAS in October 2015 for a one-year period Total award = $978,401

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES The NC CCBHC Planning Project, continued Funds will be used for the following: –Personnel (Project Director, Grants Coordinator, Research/Administrative Assistant) –Development of PPS/consultation with actuarial agency –Development of data collection/reporting methodologies –Development of electronic health records –Training on EBPs –Certification process –Marketing/Training/Information Dissemination

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES MAJOR PROJECT ACTIVITIES

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES A. Solicit Input Establish a steering committee to guide and provide input Conduct outreach, recruit and engage the population(s) of focus in the solicitation of input Coordinate activities with other local, state, federal agencies and tribes to ensure that services are accessible and available

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES B. CCBHC CERTIFICATION Construct an instrument to determine the extent to which the community behavioral health clinic or FQHC meets each of the specified criteria for certification Determine selection process Establish an objective panel of experts who will rate applicants on the eligibility criteria and make their recommendations to the State Conduct a needs assessment of the catchment area where the community behavioral health center or federally qualified health center (FQHC) operates ;

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES B. CCBHC CERTIFICATION (continued) Certify at least two community behavioral health clinics (one rural, one urban) Assist clinics with meeting certification standards

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES C. Establish PPS Methodology Obtain guidance from SAMHSA/CMS Consult with LME/MCOs Consult with an actuarial agency

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES D. CCBHC Services Crisis mental health services, including 24-hour mobile crisis teams, emergency crisis intervention services and crisis stabilization Screening, assessment and diagnosis, including risk assessment Patient-centered treatment planning, including risk assessment and crisis planning Outpatient mental health and substance use services

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES D. CCBHC Services, continued Outpatient clinic primary care screening and monitoring of key health indicators and health risk Targeted case management Psychiatric rehabilitation services Peer support and counselor services and family supports Intensive, community-based mental health care for members of the armed forces and veterans

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES E. Data Collection Develop/enhance data collection and reporting capacity to meet grant program requirements Use a cost report format that is developed to conform to CMS guidance, collect cost reports from CCBHCs Assist CCBHCs with preparing to use data to inform and support continuous quality improvement processes within CCBHCs

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES F. National Evaluation of Demonstration Program Collaborate with the national evaluation planning team Construct a comparison group Obtain Institutional Review Board approval as necessary

N.C. DEPARTMENT OF HEALTH AND HUMAN SERVICES G. Proposal for Demonstration Program Submit a proposal to participate in the demonstration program Proposals are due by October 31, 2016